| Doctor Name: | HEIDI L MANCUSI |
| NPI Number: | 1003833823 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PT, RN |
| License Number: | 9816-24 |
| Business Practice Address: | 600 Highland Ave Compliance Mail Code-2433 Madison, WI - 537920001 |
| Business Phone Number: | 6086620817 |
| Business Fax Number: | |
| Mailing Address: | 600 Highland Ave, Compliance Mail Code-2433 MADISON |
| State: | WI |
| Postal Code: | 537920001 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 07/16/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251N0400X |
| License Number: | 9816-24 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Neurology |
| Taxonomy Definition: | |